| NPI | 1013656057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03441864) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 70468) |
| Enumeration Date | 2022-05-28 |
| Last Update Date | 2024-04-18 |